In a study of unintended pregnancies occurring in Oklahoma, the Oklahoma State Department of Health (OSDH) found that 37 percent of women with a recent live birth in Oklahoma did not intend to become pregnant at the time of conception.

The study was conducted using a random statewide survey called PRAMS, which analyzed the characteristics of women reporting live births in Oklahoma from 2000 to 2003. The study found that approximately 30 percent of women did not mind becoming pregnant and only one-third of mothers indicated that their pregnancies were intended.

Unintended pregnancy is defined as a pregnancy that was not wanted at the time of conception (either unwanted or mistimed). Intention is an important aspect of pregnancy as unintended pregnancies are associated with multiple health risks to mother and baby, including alcohol and tobacco use during pregnancy, inadequate prenatal care, domestic violence, and lower likelihood of breastfeeding.

“We know that family planning programs are vital to improving the health of Oklahoma’s mothers and children,” said State Health Commissioner Dr. Michael Crutcher. “Now, the results from this study reveal that more resources should be directed at preconception health counseling for all women as part of routine health exams.”

The PRAMS study showed that women who were low-income, single, African-American, under age 20, with less than a high school education, and received Medicaid, were most likely to have an unintended pregnancy.

The most significant findings from the study include the following:

Thirty-seven percent of women did not want to become pregnant at conception.

Twenty-eight percent of Oklahoma women stated that they did not mind becoming pregnant. These women were the most likely to have mistimed their pregnancies by less than one year.

A little more than 35 percent of mothers indicated that their pregnancies were intended at conception.

Adolescents reported the highest percentage of unintended pregnancies (63.7 percent) and were the most likely to mistime their pregnancy by more than four years.

Family planning services are an economical solution to the issue of unintended pregnancy. While promoting family involvement, preventive health education, and screening, these services are designed to provide males and females of reproductive age with the capacity to plan their families. The U.S. Department of Health and Human Services Healthy People 2010 report shows that for every $1 invested in family planning services, $3 are saved in costs related to Medicaid pregnancy and newborn care.

In Oklahoma, the SoonerPlan program provides low-income women and men over the age of 19, who are not eligible for traditional Medicaid, with family planning services. OSDH estimates that by providing SoonerPlan services, Oklahoma saves about $3.7 million per year.

Based on the PRAMS survey results, public health officials offer the following recommendations:

Expand adolescent health services, especially in low-income communities where the needs for health education programs and services are the greatest.

Provide preconception care and counseling as part of routine health and wellness checks for women.

Increase awareness of family planning services available to both Medicaid and non-Medicaid low-income women, especially those at risk for an unintended pregnancy.

Assist clients, who may be eligible, in completing the application for the SoonerPlan family planning program.

Increase access to, and use of more effective contraceptive methods that have lower failure rates and are easy to be used, such as IUDs, Depo-Provera, Ortho-Evra (the Patch) and the Nuva Ring.

Review the correct use of a woman’s chosen contraceptive method at every clinical encounter.

Advocate for the research and development of a variety of contraceptive options for men.

Increase public awareness and education about the role and responsibility of men in contraception use and parenting.

For information about family planning services or SoonerPlan, contact Jill Nobles-Botkin, OSDH MCH Consultant, at 405-271-4476, or call the county health department in your area. More information about SoonerPlan is also available at http://www.okhca.org/client/programs/family/family.asp.